Participant Feedback Form[Exercise Name]

Participant Feedback Form

Thank you for participating in this exercise. Your observations, comments, and input are greatly appreciated, and provide invaluable insight that will better prepare our nation against threats and hazards. Any comments provided will be treated in a sensitive manner and all personal information will remain confidential. Please keep comments concise, specific, and constructive.

Part I: General Information

Please enter your responses in the form field or check box after the appropriate selection.

Name: ______

Agency/Organization Affiliation: ______

Position Title: ______

Years of Experience in Present Position: ______

Number of Exercises Previously Participated in: 0 1-5 5-10 15+

Exercise Role: Player Facilitator/Controller Observer Evaluator

Location during Exercise: ______

Part II: Exercise Design

Please rate, on a scale of 1 to 5, your overall assessment of the exercise relative to the statements provided, with 1 indicating strong disagreement and 5 indicating strong agreement.

Assessment Factor / Strongly
Disagree / Strongly Agree
Pre-exercise briefings were informative and provided the necessary information for my role in the exercise. / 1 / 2 / 3 / 4 / 5
The exercise scenario was plausible and realistic. / 1 / 2 / 3 / 4 / 5
Exercise participants included the right people in terms of level and mix of disciplines. / 1 / 2 / 3 / 4 / 5
Participantswere actively involved in the exercise. / 1 / 2 / 3 / 4 / 5
Exercise participation was appropriate for someone in my field with my level of experience/training. / 1 / 2 / 3 / 4 / 5
The exercise increased my understanding about and familiarity with the capabilities and resources of other participating organizations. / 1 / 2 / 3 / 4 / 5
The exercise provided the opportunity to address significant decisions in support of critical mission areas. / 1 / 2 / 3 / 4 / 5
After this exercise, I am better prepared to deal with the capabilities and hazards addressed. / 1 / 2 / 3 / 4 / 5

Rev. April 20131[Sponsor Organization]

HSEEP-C09Homeland Security Exercise and Evaluation Program (HSEEP)

Participant Feedback Form[Exercise Name]

Part III:Participant Feedback

1.I observed the following strengths during this exercise (please select the corresponding capability and applicable element related to the strength):

Strengths / Core Capability / Element
[list core capabilities for this exercise] / Planning
Organization
Equipment
Training
Exercise
[list core capabilities for this exercise] / Planning
Organization
Equipment
Training
Exercise
[list core capabilities for this exercise] / Planning
Organization
Equipment
Training
Exercise

2.I observed the following areas for improvement during this exercise(please select the corresponding capability and applicable element related to the area for improvement):

Areas for Improvement / Core Capability / Element
[list core capabilities for this exercise] / Planning
Organization
Equipment
Training
Exercise
[list core capabilities for this exercise] / Planning
Organization
Equipment
Training
Exercise
[list core capabilities for this exercise] / Planning
Organization
Equipment
Training
Exercise

Rev. April 20131[Sponsor Organization]

Homeland Security Exercise and Evaluation Program (HSEEP)

Participant Feedback Form[Exercise Name]

3.What specific training opportunitieshelped you (or could have helped you) prepare for thisexercise? Please provide specific course names if applicable.

Training / Completed Prior to Exercise? (Y/N)

4.Whichexercise materials were most useful? Please identify any additional materials or resources that would be useful.

5.Please provide any recommendations on how this exercise or future exercises could be improved or enhanced.

Rev. April 20131[Sponsor Organization]

Homeland Security Exercise and Evaluation Program (HSEEP)